Healthcare Provider Details

I. General information

NPI: 1841090362
Provider Name (Legal Business Name): EFIRD NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ASHBURN PL
GREENVILLE SC
29615-3605
US

IV. Provider business mailing address

21 ASHBURN PL
GREENVILLE SC
29615-3605
US

V. Phone/Fax

Practice location:
  • Phone: 919-685-5471
  • Fax:
Mailing address:
  • Phone: 919-685-5471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: ELAINA EFIRD
Title or Position: OWNER/REGISTERED DIETITIAN
Credential:
Phone: 919-685-5471